“One of the potential dangers if you prematurely let a vaccine out is that it would make it difficult, if not impossible, for the other vaccines to enrol people in their trial.”
Large-scale clinical trials of the leading vaccine candidates from Moderna Inc, Pfizer Inc and AstraZeneca Plc, which aim to enrol tens of thousands of volunteers, were launched in recent weeks. Johnson & Johnson last week said it hopes to include 60,000 subjects in its phase three vaccine trial.
Trump stoked concerns of politicising the regulatory approval process with an announcement on Sunday of an emergency use authorisation for plasma from recovered COVID-19 patients to treat current patients before its benefits have been assessed in random, placebo-controlled clinical trials.
Trump had tweeted on Saturday that “deep state” elements at the FDA were delaying progress on drugs and vaccines until after the November 3 election in order to hurt his reelection bid.
Safe and effective vaccines are seen as essential to ending the pandemic that has claimed the lives of more than 800,000 people worldwide, over 177,000 of them in the United States.
But vaccine experts worry that the White House may apply pressure on the FDA to push out a vaccine via an EUA before it has been fully tested – a pathway that has never been used to approve a vaccine intended for widespread use.
“I would be very worried about using an EUA mechanism for something like a vaccine. It’s very different from plasma therapy,” said Dr Peter Hotez, an infectious disease expert and vaccine researcher at Baylor College of Medicine.
Fauci said the FDA’s guidance on vaccines – both for full approval and for an EUA – explicitly requires a demonstration that it is both safe and effective.
An EUA is typically used for products to “diagnose, prevent and treat serious or life-threatening diseases where the known benefits outweigh the potential risks of the product”, Fauci said.
An EUA might be appropriate once studies have shown safety and effectiveness, but before the FDA has completed its formal review of the company’s marketing application, he said.
“To me, it’s absolutely paramount that you definitively show that a vaccine is safe and effective, both,” Fauci said. “We would hope that nothing interferes with the full demonstration that a vaccine is safe and effective.”
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